Neurosurg Focus. 2020 Mar 1;48(3):E16. doi: 10.3171/2019.12.FOCUS19808.
It is estimated that nearly 47 million preventable deaths occur annually due the current worldwide deficit in surgical care; subsequently, the World Health Organization resolved unanimously to endorse a decree to address this deficit. Neurosurgeons from industrialized nations can help address the needs of underserved regions. Exposure during training is critical for young neurosurgeons to gain experience in international work and to cultivate career-long interest. Here, the authors explore the opinions of current residents and interest in global neurosurgery as well as the current state of international involvement, opportunities, and barriers in North American residency training.
An internet-based questionnaire was developed using the authors' university's REDCap database and distributed to neurosurgical residents from US ACGME (Accreditation Council for Graduate Medical Education)-approved programs. Questions focused on the resident's program's involvement and logistics regarding international rotations and the resident's interest level in pursuing these opportunities.
A 15% response rate was obtained from a broad range of training locations. Twenty-nine percent of respondents reported that their residency program offered elective training opportunities in developing countries, and 7.6% reported having participated in these programs. This cohort unanimously felt that the international rotation was a beneficial experience and agreed that they would do it again. Of those who had not participated, 81.3% reported interest or strong interest in international rotations.
The authors' results indicate that, despite a high level of desire for involvement in international rotations, there is limited opportunity for residents to become involved. Barriers such as funding and rotation approval were recognized. It is the authors' hope that governing organizations and residency programs will work to break down these barriers and help establish rotations for trainees to learn abroad and begin to join the cause of meeting global surgical needs. To meet overarching international neurosurgical needs, neurosurgeons of the future must be trained in global neurosurgery.
由于目前全球外科护理的不足，全球每年估计有近 4700 万人因此而可预防的死亡；随后，世界卫生组织一致决定通过一项决议来解决这一不足。来自工业化国家的神经外科医生可以帮助满足服务不足地区的需求。培训期间的接触对于年轻的神经外科医生获得国际工作经验和培养长期职业兴趣至关重要。在这里，作者探讨了当前住院医师对全球神经外科学的看法和兴趣，以及北美住院医师培训中国际参与、机会和障碍的现状。
使用作者所在大学的 REDCap 数据库开发了一个基于互联网的问卷，并分发给美国 ACGME（研究生医学教育认证委员会）批准的项目中的神经外科住院医师。问题集中在住院医师的项目参与情况和国际轮转的后勤工作，以及住院医师对追求这些机会的兴趣程度。
从广泛的培训地点获得了 15%的回复率。29%的受访者报告说，他们的住院医师项目提供了在发展中国家进行选修培训的机会，有 7.6%的人报告参加了这些项目。这一组人一致认为国际轮转是一次有益的经历，并同意再次参加。在没有参加过的人中，81.3%的人表示对国际轮转有兴趣或强烈的兴趣。
作者的结果表明，尽管大多数住院医师都渴望参与国际轮转，但他们参与的机会有限。资金和轮转批准等障碍得到了认可。作者希望管理组织和住院医师项目将努力打破这些障碍，帮助为学员建立海外轮转，并开始参与满足全球手术需求的工作。为了满足全球神经外科学的总体需求，未来的神经外科医生必须接受全球神经外科学的培训。
